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As regular readers are aware, Fiona Reynolds attended the two day Public Health England (PHE) Conference on the 16th and 17th September. Today's blog entry focuses on the early morning session to discuss the UK's response to ebola which provided an update on the latest developments in West Africa.The aim was to provide an insight in to the evolution of the outbreak and how PHE has been worked across government, International agencies and NGOs during the early phase of the response. It reported on the current situation at the time of the conference and described how PHE will further respond to the outbreak and how PHE staff and others can be involved. The following notes are Fiona's reflections on the meeting.It seemed to me that the overarching tone of this session was one of anger and embarrassment - that more hadn't been done sooner by the international community to support the affected countries in the face of a stark situation. Mark Salter succinctly demonstrated the feeling in the room: "Nurses and doctors have died... working day and night with little or no support from the global community".Mark is a Consultant for Global Health with Public Health England (PHE), UK. In this role he coordinates the international efforts of the PHE in establishing bilateral links with nation states and regional networks as well as responding to requests for public health assistance in response to public health emergencies and humanitarian crises.The PHE support to Sierra Leone has included direct support: technical, epidemiology, infection control and non-ebola diagnostic laboratory support because while ebola dominates efforts and attention, there continue to be other diseases to deal with. The UK/PHE focus is on Sierra Leone though the organisation supports other areas too. Other affected countries have other international partners.PHE had originally gone to Sierra Leone to support the establishment of a Public Health Institute - efforts are now the building is a field hospital to support the ebola outbreak. There as been a National Health Service (NHS) recruitment drive for find clinical workers and PHE will also place its staff in technical/training roles. The intention is to put the right people in the right roles.There were a number of people who were sharing their experiences, having recently returned from Sierra Leone where they had been supporting local efforts there. Unfortunately, I didn't manage to note everybody's names.One speaker described efforts to implement contact tracing and contact monitoring - attempting to reach 500 people per day and this was a month ago. He concluded that the numbers are already much higher and described the challenge faced in attempting this in resource poor settings. A key issue was poor literacy but also the sheer physical difficulty of being able to travel across huge geographical areas to reach people.PHE is keen to ensure that the UK sends staff as well as money/resources to assist in efforts, to support staff already working in very difficult conditions. The field hospital will also provide treatment for healthcare workers who become infected. The intention will not be to airlift foreign workers back to their home countries which is resource intensive but to treat them locally.The feeling in the room was one of frustration that the international community had not engaged sooner, with more proactive support. There was real anger that this outbreak has been allowed to continue for so long without a more urgent response or earlier recognition that action needed to be taken sooner. I read an article earlier this week that compared the response in 1976 and in 2014. It seemed to conclude that there had been no recognition that the world has changed greatly in the last 40 years and that the response so far has been inadequate.This was a sombre start to the conference and I think much of the anger and sense of unfairness was carried through to the Global Health Question Time held later that day. (My notes from that session have already been published on the blog).